Academic journal article The Hastings Center Report

The State of Play on Living Wills

Academic journal article The Hastings Center Report

The State of Play on Living Wills

Article excerpt

This issue of the Hastings Center Report has two lead articles, if that is possible. The lead that leads is Arthur Franks rumination on the increasingly common use of surgery to shape a body, in order to measure up to current standards of normality and beauty. Frank hopes that we can slow the growth of what he calls "technoluxe" medicine--the use of surgery to shape a foot so that it looks beautiful in a designer shoe at a garden party, for example. It is technoluxe that leads to "Extreme Make-Over," the "reality" television program in which participants feel compelled to undergo multiple plastic surgeries in order to, for example, boost their chronic low self-esteem, walk across the street without embarrassment, or get along better with a more-beautiful sister.

Frank dismisses the idea that there could be any rules for deciding which procedures are unacceptable. He hopes rather that we will be restrained by considering the implications of our choices for others and opening our choices to the scrutiny of dialogue: he hopes for a moral, not a policy, solution.

The goals are very different for the other lead article, Angela Fagerlin and Carl Schneider's salvo on living wills. Fagerlin and Schneider argue that "no degree of tinkering [can] ever make the living will an effective instrument of social policy." When still in manuscript form, the piece was the subject of a strongly felt exchange among reviewers and within the Hastings Center's editorial committee over the status of the living will. Some held that the most careful commentators--the advance guard on advance directives--have shifted their ground, and that relatively few still cling to the living will. …

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